Tooth discoloration caused by endodontic treatment: A cross-sectional study

Abstract

Introduction: This cross-sectional study evaluated the influence of endodontic filling material, cervical limit of root filling, and tooth location on the color variation (∆E₀₀ ) from 1 to 60 months of follow-up.

Materials and methods: Color records were obtained from 70 participants who received 83 endodontic treatments. CIEL*a*b* color coordinates were measured on the homologous tooth, which was considered as baseline, and on endodontic treated teeth with a spectrophotometer. ∆E₀₀ was calculated by the CIEDE2000 method at three conditions (condition 1: homologous tooth vs endodontically treated tooth after ≤1 month; condition 2: homologous tooth vs endodontically treated tooth after >1-12 months; condition 3: homologous tooth vs endodontically treated tooth after >12 months up to 5 years) for each variable. The zinc oxide and eugenol mineral trioxide aggregate or resin-based filling materials, dental cervix or ≥2 mm in the apical direction cervical limit of root filling and anterior or posterior tooth location were considered in the comparisons. Confidence intervals for the means (95% CI) were calculated, ∆E₀₀ values and CIEL*a*b* individual color coordinates were compared for each pair of variables using the Student t test or Welch test (α = .05).

Results: Greater ∆E₀₀ values were generally observed in the condition 3 for cervical limit (∆E₀₀ = 10.7), use of zinc oxide and eugenol and mineral trioxide aggregate-based filling materials (∆E₀₀ = 10.7), and anterior teeth (∆E₀₀ = 12.4). Only in the condition 1, the ∆E₀₀ values of the filling materials did not show statistical differences (P = .198).

Conclusions: Higher ∆E₀₀ values were yielded from zinc oxide and eugenol and mineral trioxide aggregate-based filling materials, anterior teeth, and dental cervix cervical limit of root filling.

Clinical significance: Tooth discoloration yielded by endodontic materials and procedures is a challenge to clinical practice resulting in aesthetic problems and discomfort to both patient and professional, especially when it occurs in anterior teeth.

Keywords: color; endodontic sealers; root canal filling materials; root canal obturation; spectrophotometry; tooth discoloration.